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The procedure described by CPT® Code 26476 involves the lengthening of an extensor tendon in the hand or finger. This surgical intervention is typically indicated for patients who present with an extension deformity, which can occur as a result of various conditions, including the late effects of injuries or chronic diseases such as severe rheumatoid arthritis or osteoarthritis. The goal of the procedure is to correct the deformity by adjusting the length of the extensor tendon, thereby restoring normal function and alignment of the affected digit. During the procedure, a skin incision is made over the targeted tendon, allowing for careful dissection of the surrounding soft tissues to expose the tendon. A Z-shaped incision is then created in the tendon itself, which facilitates lengthening by enabling the tendon fibers to slide apart when the wrist is flexed or extended. After the tendon has been lengthened, sutures are placed to secure it in this new position. To ensure proper healing and maintain the desired length of the tendon, the hand or finger is subsequently immobilized using a splint or cast. It is important to note that this code is applicable for each tendon that is lengthened during the procedure, emphasizing the need for accurate reporting in medical coding practices.
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The procedure associated with CPT® Code 26476 is indicated for the correction of extension deformities in the hand or finger. These deformities may arise from various underlying conditions, including:
The procedure for lengthening an extensor tendon involves several key steps, which are detailed as follows:
Post-procedure care following the lengthening of the extensor tendon is critical for successful recovery. Patients are typically advised to keep the hand or finger immobilized in the splint or cast for a specified duration to ensure that the tendon heals properly in its new position. Regular follow-up appointments may be scheduled to monitor the healing process and assess the function of the hand or finger. Physical therapy may also be recommended after the initial healing phase to restore strength and range of motion, although the specifics of rehabilitation will depend on the individual patient's condition and the extent of the procedure performed.
| Short Descr | TENDON LENGTHENING | Medium Descr | LENGTHENING TENDON EXTENSOR HAND/FINGER EACH | Long Descr | Lengthening of tendon, extensor, hand or finger, each tendon | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 4 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| LT | Left side (used to identify procedures performed on the left side of the body) | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | F1 | Left hand, second digit | F2 | Left hand, third digit | F3 | Left hand, fourth digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F7 | Right hand, third digit | F8 | Right hand, fourth digit | F9 | Right hand, fifth digit | FA | Left hand, thumb | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) | T1 | Left foot, second digit |
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| Pre-1990 | Added | Code added. |
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